TRANSCRIPT: ABC News/Facebook/WMUR Republicans Debate

Jan. 5, 2008

Page 19 of 36

ROMNEY: I would not mandate at the federal level that every
state do what we do. But what I would say at the federal level is,
"We'll keep giving you these special payments we make if you adopt
plans that get everybody insured." I want to get everybody insured.

GIBSON: OK.

ROMNEY: In Governor Schwarzenegger's state, he's got a different
plan to get people insured. I wouldn't tell him he has to do it my
way.

But I'd say each state needs to get busy on the job of getting
all our citizens insured. It does not cost more money.

GIBSON: I want to give Governor Huckabee a little time. Then
we've got to go.

HUCKABEE: OK.

I think it's important to realize that the issue is not just
insurance. The issue is that the whole model of our health-care
system is upside down.

We really don't have a health-care system. We have a disease-
care system. And the insurance model that we use, we act like that if
we insured everybody, we've fixed it.

We haven't. Because the real problem is that our model, both in
the insurance model and the health-care model, waits until people are
catastrophically ill before it intervenes.

HUCKABEE: And we really have to change the concept to a
preventive focus rather than an intervention focus.

And that means the entire system starts working on health and
wellness, because 80 percent of the $2 trillion that we spend on
health care goes to chronic disease.

We could prevent it or we could cure it, but we don't. So it's
not an issue of there's not enough money to cover people.

But if a real health care system exists, it has three components:
It has affordability, it has quality, and it has accessibility.

And if it doesn't have those elements, it's not a system; it's a
maze. And what we have in America is a health care maze. It's built
on the idea that we wait until people are so desperately ill that the
cost to try to fix them is catastrophic and out of control.

And no wonder we have a system that needs major, major attention.

And by the way, just out of due respect, you said $1,000 for a
repair.

HUCKABEE: It's about $1,000 for a Kleenex at a hospital anymore.

(LAUGHTER)

And that's why we need to have a totally different system that
keeps you from going to the hospital in the first place.

(CROSSTALK)

GIULIANI: Charlie, a health savings account actually helps to
accomplish what the governor is talking about.

If somebody can put aside -- and the plans that we've been
talking about include a health savings account. You'd have an
exemption up to $15,000. If you could find a policy for $11,000, you
can have a $4,000 health savings account.

You would be able to buy some of your health care and your
prevention yourself. It gives you an incentive over a lifetime to
deal with wellness.

GIBSON: And I've got to go.

But Senator McCain has talked a lot about controlling costs, and
you bring up the issue in controlling costs. And all the experts say
to me, Look, if you're going to control costs, you got to do three
things. You're going to limit access to technology, you're going to
limit, in some way, change the reimbursement system for doctors and
hospitals, or you're going to have to limit the amount of treatments.
That's the only way we can bring costs down.

And that's the third rail of health care. Which of you is going
to touch any of that?

HUCKABEE: Charlie, that's not at all the way it is. The fact
is, if you had...